Managements of painless chronic pancreatitis / 中华消化内镜杂志

ABSTRACT

Objective To explore the treatments and their effects on painless chronic pancreatitis (CP) in adult. Methods A historical cohort study of adult subjects with CP, who were hospitalized in our center in the last decade, was performed, and the clinical data were analyzed. Results There were 56 cases of adult painless CP, and 46 (82.1%) (31 males and 15 females, age 51.6±14.5 years) were followed up(34.5±27.1 months). Imaging findings showed 26 cases of pancreatic duct stones and morphological changes. These patients received endoscopic intervention therapy(n=14), surgical procedures(n=7), combined endoscopic and surgical treatment(n=3) and conservative treatment(n=2). Another group of 18 cases of pancreatic or peripheral occupying lesions received surgery. During follow-up of the above 2 groups, 1 patient died of pancreatic cancer in each group. The symptoms of diabetes and diarrhea were not relieved, but there was improvement of general condition in some patients. Stones re-occurred after surgery in one patient. Two patients with pancreatic duct dilation and cysts underwent endoscopic treatment(n=1) and surgical procedure(n=1), respectively. But the latter patient experienced gastric bleeding, cirrhosis and jaundice with unknown reason after the surgery. Conclusion In adult patients with CP, endoscopic and surgical procedures had similar effect in patients with pancreatic duct stones and dilation. Surgical procedures are preferably performed in those with pancreatic occupying lesions. Further study is needed in those only with pancreatic duct dilation. The above treatments can improve general conditions in some patients. Intensive surveillance is suggested to the patients with painless CP.